Quest for the Perfect Anticoagulant

The current referenced meta-analysis study by Selvaraj et al1 examines the relative merits of anticoagulation with a direct oral anticoagulant (DOAC) versus vitamin K antagonist (VKA) after transcatheter aortic valve implantation (TAVI) in patients meeting the indications for anticoagulation because of atrial fibrillation (AF). Although guidelines vary, the general consensus appears to indicate noninferiority to superiority of DOACs in the treatment of nonvalvular AF. In the landmark Apixiban for Reduction In Stroke and Other Thromboemoblic Events in Atrial Fibrillation trial comparing apixaban to warfarin in patients with AF, apixaban was associated with a superior prevention of stroke and thromboembolism, decreased bleeding events, and decreased mortality over a median follow-up of 1.8  years.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research